AIDS 2010 Roundup: Men Who Have Sex With Men (MSM)

Prevention Is Failing Young MSM in the U.S.

While safer sex information is out there for gay and bisexual teens, somehow the information is not setting in. Past studies show that young MSM understand how HIV is transmitted, but still engage in unprotected anal intercourse anyway. A recent study conducted by researchers from Emory Healthcare in Atlanta looked to understand why this dichotomy exists and expose the reasons why young men are not making the connection that what they are doing is risky.

AIDSmeds.com reported:

D. Dennis Flores III, from Emory Healthcare in Atlanta and his colleagues conducted interviews with 10 young MSM from that city who had recently been diagnosed with HIV. Nine of the men were African American, and one was Latino. Their ages ranged from 18 to 24. The interviews with the young men covered four topic areas: risk behavior, HIV education, the Internet and healthy role models.

As has been found in previous studies, the majority of the young men had viewed themselves as either unlikely or very unlikely to contract HIV in their lifetimes, and half reported experiencing coercion and sexual abuse at the time of sexual initiation. ...

Flores and his colleagues found that while all the young men had undergone sex education while in middle school or high school, none reported that these classes included information about gay sex. Moreover, only one of the young men reported having any gay role models while growing up. This meant that relevant sex education occurred on the Internet, which from a sexual risk perspective, can be quite perilous. When these young men went online, most of them saw graphic high-risk sexual encounters, and this behavior quickly became what they perceived as normal and desirable.

One of the most interesting findings from the study was that by the time prevention messages reached the young men, it was too late -- unprotected sex had become a normal part of their everyday. Flores recommended the following: that sex education should happen as young as elementary school and middle school; parents need to be more supportive and teach their sons about the dangers of sexual coercion; and that new online prevention strategies need to be developed to reach the young people where they are.

HPV Vaccine Prevents HPV Lesions and Infection in Men

While Gardasil -- a vaccine designed to protect against the four strains of human papillomavirus (HPV) -- has been approved for young girls and women for a few years, there has been much interest in whether the vaccine can work for gay and bisexual men. HPV in men can lead to anal, penile and other cancers.

AIDSmeds.com wrote that the first ever clinical trial to test the safety and efficacy of Gardasil in gay and bisexual men "demonstrated a significant reduction in the number of pre-cancerous anal lesions caused by HPV." The trial was led by Heiko Jessen, M.D., of Praxis, a private medical clinic in Berlin.

They also wrote:

Jessen's group randomized 4,065 men -- 3,463 heterosexual men between 16 and 23 years old and 602 MSM between 16 and 26 years old -- to receive three doses (a first injection, followed by a second two months later and a third four months after that) of Gardasil or placebo and were followed for about 36 months. The men were enrolled at sites in 18 countries on five continents. ...

Safety data were available for 1,945 men in the Gardasil group and 1,950 men in the placebo group. About 64 percent of Gardasil recipients experienced one or more vaccine-related adverse event -- including injection-site problems and systemic complaints -- in the study, but so did 58.2 percent of those in the placebo group.

Serious adverse events -- including appendicitis, cellulitis, chest pain and peanut allergy -- were documented in 0.3 percent and 0.1 percent of those in the Gardasil and placebo groups, respectively. However, when the researchers looked for serious adverse events clearly attributed to vaccination, the rates were 0 percent in both groups.

Another study is planned for a vaccine designed to protect against nine types of HPV.

Related Media:

• HPV Vaccine Prevents HPV Lesions and Infection in Men (From NATAP)
• High HIV Incidence for Thai Men Who Have Sex With Men; Many Acquiring HIV in Their Early Twenties (From aidsmap.com)
• UK: One in Six Gay Men Testing HIV-Positive Were Infected Recently (From aidsmap.com)
• A Year of ART Does Not Ease Anal Cancer Harbingers in Men (From NATAP)
• Internet Proving a Key Way to Reach Men Who Have Sex With Men in Africa, Asia and Beyond (From aidsmap.com)
• Penal Reform, Decriminalization of Illicit Drugs, and Increased Advocacy All Central to Improving Prisoners' Health (From aidsmap.com)